Serum Calcitonin Levels may be Used in the Differential Diagnosis of Vagal Glomus.
Medullary thyroid carcinoma is a neuroendocrine tumor and is very
rarely observed. MTC originates from the parafolliculer C cell
and can show various histopathological
patterns. Head and neck
paragangliomas are seen rarely. Paragangliomas
in the head and neck
region are usually non-functional.
MTC should be considered in the differential diagnosis of
paragangliomas in the head and neck region. A high degree of
clinical investigation is needed to
determine the rare potential etiology underlying this condition.
Because patients with MTC can
present different clinical
manifestations, otolaryngologist must be aware of MTC and its rare
medical presentations.
This case presented here highlights the
importance of serum calcitonin levels in the differential diagnosis of
paragangliomas in the head and neck region.
Medullary thyroid carcinoma is a neuroendocrine
tumor and comprises lesser than 10% of all thyroid malign tumors. So it is a very rarely
occuring tumor in all malignancies.
Due to recent Surveillance, Epidemiology, and
End Results data in the United States,
MTC accounts for 1% to 2% of all thyroid cancers.
A large part of the medullary carcinomas
are sporadic, and familial form constitutes nearly 25%. The 10-year survival rate of MTC is
approximately about 75% with
respect to current literature.
The MTC spreads early to both paratracheal and lateral cervical
lymph nodes, and distant spreading occurs in the liver,
lungs, bones, and less frequently in brain and skin.
All the patients undergoing a
pre-operative diagnosis of MTC
should be evaluated
with a detailed neck ultrasonography
and measurement of
serum calcitonin and carcinoembryonic antigen.
Basal serum
calcitonin concentrations usually can be
linked to tumor burden
but also indicates tumor differentiation in MTC.
Otolaryngol Open J. 2017; 3(1): 22-26. doi: 10.17140/OTLOJ-3-136